Fentanyl continues to lead record opioid deaths in Maryland

Overdose deaths in Maryland related to heroin, fentanyl and other opioids continued to spike, reaching a new high in the first nine months of 2017, according to numbers released Friday by the state health department.

The powerful synthetic opioid fentanyl accounted for most of the deaths. Sometimes added to heroin or cocaine without the user knowing, fentanyl is 50 to 100 times more potent than heroin and can kill those who come in contact with even minuscule amounts of it.

Maryland experienced 1,501 opioid-related deaths from January to September last year, including 1,173 deaths tied to fentanyl, according to the Maryland Department of Health. Fentanyl was present in two-thirds of fatal cocaine overdoses, which spiked 47 percent from last year.

The even more potent carfentanil, a large animal tranquilizer, also broke out as a new scourge, accounting for 57 deaths last year, compared to none the year before when screening for it began. Carfentanil is 100 times more potent than fentanyl.

Even as fentanyl and carfentanil deaths jumped, there was a slight decline in the number of heroin-related and prescription opioid-related deaths when comparing data for 2016 and 2017 through September.

The numbers reflect the difficulty public health authorities and law enforcement still face in trying to curb an opioid epidemic that continues to flourish and kill despite numerous initiatives to address the problem.

“We have not even seen where the peak of this epidemic is going to be,” Baltimore City Health Commissioner Dr. Leana Wen said. “We are not at the peak of the epidemic and there is no end in sight. We don’t know how much worse the problem is going to get. This is why there needs to be even more urgency around the issue.”

Governor Larry Hogan launched an opioid operational command center last year to coordinate efforts across the state to combat the epidemic, among other initiatives. The state also expanded access to naloxone, the drug that can reverse an overdose, and issued a standing order that allows pharmacies to dispense naloxone to people at risk of an overdose or who can help someone who overdoses.

Earlier this week, the governor said he plans to introduce legislation that will add fentanyl to the list of drugs that carry tougher penalties if sold in high volumes. Other proposed legislation would create a statewide database that would allow first responders to track opioid overdoses so they can send resources to specific areas that are being hit hard.

The Maryland health department issued a warning about fentanyl in 2016 and did so again Friday in announcing the new overdose numbers.

“I want to reiterate the dangers of it and other synthetic drugs, which are the leading cause of overdose deaths in Maryland,” Health Secretary Robert R. Neall said in a statement. “We implore Marylanders who are grappling with substance use disorders and are taking illicit substances to seek treatment immediately, and for others to take advantage of the standing order for naloxone by learning how to administer it and carry it with them.”

Fourteen counties in the state saw an increase in opioid-related deaths. The largest number of deaths were in Baltimore, where 523 people overdosed between January and September, 80 more than the year before. Baltimore County had the second largest number of deaths: 238, 19 more than in 2016.

In Baltimore, the city health department has been working to improve access to treatment and warn users in real time through text messages where fentanyl is being sold or used so people can avoid the area. But some users instead head to the flagged location to seek out the more powerful drug. A shortage of naloxone also may be hurting efforts to stop overdose deaths.

Wen is working to have bupenorphine, a drug used to wean people off opioids, available in every city emergency room. She has been meeting with hospital executives to discuss additional roles they can play in helping stop the epidemic.

“Hospitals are equipped to treat patients with all other diseases,” Wen said. “They should be just as equipped to treat the disease of addiction.”

Anne Arundel County, which had the state’s third highest number of overdose deaths — 157 — is relying more heavily on educational programs for families and in schools to steer people away from drugs. Residents now can access treatment through local fire stations.

“Anne Arundel County has been harder hit than many other jurisdictions, and the numbers are not good news and quite depressing,” said Owen McEvoy, a county spokesman. “The county executive and other elected officials believe education is very important and we have to work to teach young people about the dangers of substances and open up treatment options.”